| NPI | 1790905230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 12794) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 12794) |
| 122300000X Dentist (Licence: IL 019027091) | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2022-10-10 |